Infectious meningitis and encephalitis
Michał Makowiecki1, Agnieszka Bednarska1, Marcin Paciorek1, Dominik Bursa1, Dawid Porowski1, Anna Furman-Dłubała2, Anna Czyżyk2, Tomasz Laskus1
Affiliation and address for correspondenceThis review article addresses the topic of central nervous system infections, specifically meningitis and encephalitis of infectious aetiology. It discusses the epidemiology (including the prevalence of individual pathogens and their geographic distribution) as well as currently recommended diagnostic methods, such as cultures of cerebrospinal fluid and other clinical materials, latex agglutination tests, polymerase chain reaction, serology, histopathology, antigen testing, fluorescence hybridisation, spectrometry, next-generation sequencing, imaging studies including computed tomography and nuclear magnetic resonance, and both conventional and electron microscopy. The article also describes treatment recommendations organised according to the etiological factor (bacteria, viruses, fungal pathogens, and parasites) and patient age. Other recommended interventions, such as reversal of immunosuppression and surgery, are also addressed. Diagnostic protocols for specific diseases are discussed in detail. Furthermore, the anatomy of the central nervous system is described, and other types of neuroinfections are listed, along with a discussion of their potential co-occurrence, and non-infectious factors causing meningitis, such as neoplastic diseases, systemic diseases, and medications. The section on meningitis describes characteristic symptoms of the disease and highlights differences between hospital-acquired (nosocomial) and communityacquired meningitis. Mollaret’s disease (recurrent meningitis caused by human herpesvirus 2), post-infectious encephalomyelitis, vaccines used to prevent CNS infections, and differences in disease presentation between immunocompromised and immunocompetent patients are also discussed.











